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GAVINO DERMATOLOGY, PLLC
NPI 1619609682
Dermatology in Liberty Hill, TX

Active since June 28, 2022
9073 W STATE HIGHWAY 29 STE 108, LIBERTY HILL, TX 78642(737) 377-3143(737) 200-8237 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2026, May 21, 2026, Sep 18, 2025 and 5 more (8 updates tracked since 2022).

About Gavino Dermatology, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GAVINO DERMATOLOGY, PLLC (NPI 1619609682) is a healthcare organization registered as a dermatology in Liberty Hill, Texas and active in the NPI registry since June 2022. The organization maintains a secondary practice location in Lakeway and lists Alde Carlo Patdu Gavino, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1619609682
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameGAVINO DERMATOLOGY, PLLC
Location Address9073 W STATE HIGHWAY 29 STE 108Liberty Hill, TX 78642-2396
Mailing Address9073 W State Highway 29 Ste 108Liberty Hill, TX 78642-2396 · (737) 377-3143 · Fax (737) 200-8234
Phone(737) 377-3143
Fax(737) 200-8237
Organization SubpartNo
Authorized OfficialAlde Carlo Patdu GavinoMd/owner · (737) 377-3143
Enumeration DateJune 28, 2022
Last NPPES UpdateAugust 13, 20268 updates tracked since enumeration
NPPES CertifiedAugust 13, 2026
✔ NPI 1619609682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
9073 W STATE HIGHWAY 29 STE 108, Liberty Hill, TX 78642
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Secondary Practice Location 1

Location 13502 Wild Cherry Dr Bldg 1Lakeway, TX 78738-1826 · Phone (737) 377-3143 · Fax (737) 200-8237

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Sendero Health Plans, Local Nonprofit.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gavino Dermatology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gavino Dermatology, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Alde Gavino, M.D.
Dermatology
NPI 1255534863
9073 W STATE HIGHWAY 29 STE 108
Liberty Hill, TX 78642
(737) 377-3143
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gavino Dermatology, PLLC's NPI number?

The NPI number for Gavino Dermatology, PLLC is 1619609682. It was assigned to this organization in the NPPES registry on June 28, 2022.

Where is Gavino Dermatology, PLLC located?

Gavino Dermatology, PLLC is located at 9073 W State Highway 29 Ste 108, Liberty Hill, TX 78642. The listed phone number is (737) 377-3143.

What is Gavino Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Gavino Dermatology, PLLC enrolled in Medicare?

Yes. Gavino Dermatology, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gavino Dermatology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Gavino Dermatology, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Gavino Dermatology, PLLC accept?

Health plans from Moda Health Plan, Inc. and Sendero Health Plans, Local Nonprofit list Gavino Dermatology, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gavino Dermatology, PLLC was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.